Clinical Negligence?

[Debbielou]

My 86 year old mother broke her hip in August this year and received a partial hip replacement to repair the damage. This was a success and 3 weeks later she was discharged from hospital to a nursing home with a recently opened rehabilitation unit. On many ocasions I visited and there was no water in her room and I brought this to the attention of the nursing staff there. Morning medication was being administered around lunchtime - this consisted of pain relief very necessary to help my mother mobilise. I have many other minor complaints that I won't go into. After she had been there about a month she became very ill. I went immediately to the home to be told that the doctor had been called. He arrived about 4 hours later - and did not conduct a physical examination (no blood pressure, no heart/pulse) although he listened to her chest. My mother at this time was extremely confused which was not normal for her, she was unable to stand when 2 days previously she had been walking with the aid of a zimmer frame the length and breadth of the corridors and she was unable to feed herself and was continually falling asleep. The doctor stated that all her vital signs were normal and that all she needed was more fluid - I stayed with her for around 9 hours that day in a bid to try and get her to drink fluids. He also ordered blood tests to check kidney function. The next day my mother continued much the same and I spent the whole day by her side. The doctor visited again late that afternoon. Results of the blood tests revealed that her one and only kidney was not working adequately. He again failed to do a proper physical examination eg. no pulse, listen to heart, blood pressure etc. He said that we had to get her to drink 2 litres of fluid over the next 24 hours. When I said that given her current mental status that this was impossible. He then decided to admit her to hospital and ordered a non emergency ambulance which took 4 hours to arrive. The paramedics on connecting her to monitors in the ambulance found that her blood pressure was extremely low with a very slow and irregular heart beat which meant that she was rushed with urgency to hospital with blue lights and sirens on. On arrival at the hospital I accessed the letter of referral by the doctor who had visited her earlier that day and on it there was a blood pressure reading which was within the normal range. I queried where this blood pressure reading had come from with the staff at the nursing home the next day and the nurse in charge stated that her blood pressure was being monitored on a four hourly basis - something that is totally untrue as I was with her for 9 and 10 hours over a two day period and no-one checked her blood pressure at all. At the hospital my mother was diagnosed with acute renal failure with very high potassium levels which could have had fatal consequences. Thanks to the hospital staff she is now recovering although may never be able to return home because of the shock and stress to her system which has taken its toll on her as well as nearly 3 weeks of immobility whilst in hospital. I would welcome your comments on how to proceed in this case as I personally think that the doctor attending to her should have admitted her far sooner than he did and the staff at the home should have been monitoring her vital signs more closely.

 

I have writted a letter of complaint although this has not been sent as yet as I am a little afraid of the come back on this as the letter quite clearly acuses the doctor and to a lesser extent the nursing staff of clinical negligence.

 

I would welcome any advice that you could give me on this matter. Many thanks in anticipatin of your replies.

[BankFodder]

I should hold off before starting to make complaints. These institutions are renowned for bringing down the barriers.

 

You need to start moving stealthily and collecting information.

 

You need to make sure that you have a file containing a full chronology of everything that has happened. names, times daes - the lot. Keep on adding to it as things occur to you.

 

next you need to get copies of notes. I'm not sure what the rules are on disclsoure of this kind of information are. You need to search around the net and find out.

Is your mother mentally competent. I think that it would be best if she signed a request for her own records herself. Also it would be very good if she gave you power of attourney to act for her in this matter. You wouldn't want to disclose the power of attourney as this would spook them. A request from her to see records may alarm them a little less.

Search Google for

freedom of information hospital records

 

Also:-

data protection personal data hospital records subject access

 

It seems that your mother has a right to see her records although they can charge for copies.

 

Once you have all of the information whcih you think is available then under the authority of the power of attourney, you can begin your complaint.

 

Ideally you would go to another doctor and get an independent assessment based upon the information you have obtained. The doctor could even visit the hospital and perform his own examination. this would be costly but you would get your money back if your claim was founded.

I think that to make any headway you would have to insist upon the complaint going to the NHS Ombudsan at least

[Guest Old_andrew2018]

IMHO you need to look at the Care Quality Commission site Care Quality Commission seeking out their complaints procedure with reguard to care homes, as BankFodder suggests collect all information first.

[Sali]

Good advice from the above posts. Get as much information as possible without alerting anyone of your intention to complain.

 

Also the AVMA offer free and confidential advice www.avma.org.uk

 

Their initial response to your complaint will almost certainly thank you for your feedback with promises to use it to improve procedures. Don't take them at their word.

[Debbielou]

I have been provided with a patient consent form by the Local Primary Care Trust for my mother to sign enabling me to act as complainant on her behalf as well as the release of any relevant medical information necessary in investigating the complaint.

[Paul Heathcote]

Good advice from the above posts. Get as much information as possible without alerting anyone of your intention to complain.

 

Also the AVMA offer free and confidential advice www.avma.org.uk

 

Their initial response to your complaint will almost certainly thank you for your feedback with promises to use it to improve procedures. Don't take them at their word.

I second Sali's wise words. Personally I wouldn't bother with AvMA. They seem to have lost their way over the past few years. They used to be called 'Action for Victims of Medical Accidents', now they're 'Action against Medical Medical Accidents'. Gone is the 'for Victims'!!

 

Even once you have managed to overcome the closed door policy of the legal depts of the medical profession you have the judicial system to contend with.

See: Hot under the collar over ruling - The Star

[Sali]

Are you the Mr Heathcote in the article?

 

What was the outcome? Or are proceedings ongoing?

[Paul Heathcote]

Are you the Mr Heathcote in the article?

 

What was the outcome? Or are proceedings ongoing?

 

I am.

Proceedings are ongoing despite the court being in denial and the HA's solicitors being rude and arrogant. The whole situation exists because a judge decided to 'reserve' my case to himself to help his surgeon pal out who was a Defendant.

[Sali]

Umm, it does seem the road to justice is strewn with many obstacles. Many of those involved have a reputation and money to lose, so they'll just want you to shut up and go away. I hope you battle on. Good luck.

 

Out of interest, did you take your complaint to the HCC (as was then) and the Ombudsman?

 

What were your issues with the AVMA? I have sent them some data to review. I haven't heard back yet, but I'd like to hear your views.

[Paul Heathcote]

Umm, it does seem the road to justice is strewn with many obstacles. Many of those involved have a reputation and money to lose, so they'll just want you to shut up and go away. I hope you battle on. Good luck.

 

Out of interest, did you take your complaint to the HCC (as was then) and the Ombudsman?

 

What were your issues with the AVMA? I have sent them some data to review. I haven't heard back yet, but I'd like to hear your views.

 

I am continuing the battle. I didn't bother complaining - it would have been something else to get frustrated about.

AvMA? It seems they live in a perfect world where medical records don't go missing, aren't forged and those who have made mistakes don't lie to cover their arses. I don't have issues with AvMA as such I just wish they would accept that the organisation is not what it used to be. Now it's just a toothless tiger.

[Sali]

Once again good luck and do let us know what the eventual outcome is.

[zippygbr]

my advice for you as an NHS worker here is to go to the CQC over the Nursing home and it's lack of care

 

in terms of the GP and the Nursing home go to the PCT PALS as it is likely to be the PCT funding the rehab placement

 

although your mother was admitted to the nursing home's rehab unit following an Acute Hospital stay, don't threaten the Acute trust or the Ambulance service as they may be your greatest asset - the weight of statements from A+E and Acute Medical consultants about what the GP allegedly failed to do and the efforts made by the Ambulance service, and the acute hospital staff in A+E and the assessment unit could be very beneficial

 

OP get your mother to sign the form - otherwise you will not be able to do anything ...

[Sali]

Is Debbielou an NHS worker? Certainly as a member of the public you cannot approach the CQC however much you may think the Trust is 'failing.'

[zippygbr]

Is Debbielou an NHS worker? Certainly as a member of the public you cannot approach the CQC however much you may think the Trust is 'failing.'

 

 

however a care home regardless of who is paying the fees is something which anyone can make a complaint to the CQC about

 

Concerns and complaints

 

Complain about a social care service

 

Concerns about independent healthcare

[Guest Old_andrew2018]

It is also important to remember the The Quality Care Commission do regulate health and social care in England, this includes NHS services such as hospitals

[Sali]

Just recently I contacted the CQC as I was concerned with the quality of care at my local Trust. I had raised my concerns repeatedly with the Trust, who thanked me for my feedback and then carried on providing the same poor care. The CQC would not/could not help. If the public have concerns with a hospital, they must first try to resolve the matter locally. The NHS management may well take months to respond. If you are still unhappy you must then escalate to the Ombudsman who may well take 6 plus months before they even decide whether they will investigate. All this time other patients may be suffering and dying. It's an abysmal system.

[Debbielou]

Thanks for all of your advice. I agree with you zippygbr that the ambulance and medical admissions unit are my closes allies. I have seen my mother's medical notes in the hospital which testify to the serious condition she was in when he was admitted.

 

As far as I know the nursing home is funded by the PCT which is a recent venture in a bid to improve intermediate health care services. When I have made a decision on how to proceed I will update you.

 

Many thanks for all your help